Michal Šteffl

PPARA intron polymorphism associated with power performance in 30-s anaerobic Wingate Test.

To date, polymorphisms in several genes have been associated with a strength/power performance including alpha 3 actinin, ciliary neurotrophic factor, vitamin D receptor, or angiotensin I converting enzyme, underlining the importance of genetic component of the multifactorial strength/power-related phenotypes. The single nucleotide variation in peroxisome proliferator-activated receptor alpha gene (PPARA) intron 7 G/C (rs4253778; g.46630634G>C) has been repeatedly found to play a significant role in response to different types of physical activity. We investigated the effect of PPARA intron 7 G/C polymorphism specifically on anaerobic power output in a group of 77 elite male Czech ice hockey players (18–36 y). We determined the relative peak power per body weight (Pmax.kg−1) and relative peak power per fat free mass (W.kg−1 FFM) during the 30-second Wingate Test (WT30) on bicycle ergometer (Monark 894E Peak bike, MONARK, Sweden). All WT30s were performed during the hockey season. Overall genotype frequencies were 50.6% GG homozygotes, 40.3% CG heterozygotes, and 9.1% CC homozygotes. We found statistically significant differences in Pmax.kg−1 and marginally significant differences in Pmax.kg−1 FFM values in WT30 between carriers and non-carriers for C allele (14.6±0.2 vs. 13.9±0.3 W.kg−1 and 15.8±0.2 vs. 15.2±0.3 W.kg−1 FFM, P = 0.036 and 0.12, respectively). Furthermore, Pmax.kg−1 FFM strongly positively correlated with the body weight only in individuals with GG genotypes (R = 0.55; p<0.001). Our results indicate that PPARA 7C carriers exhibited higher speed strength measures in WT30. We hypothesize that C allele carriers within the cohort of trained individuals may possess a metabolic advantage towards anaerobic metabolism.

Relationship between sarcopenia and physical activity in older people: a systematic review and meta-analysis

Physical activity (PA) has been identified as beneficial for many diseases and health disorders, including sarcopenia. The positive influence of PA interventions on sarcopenia has been described previously on many occasions. Current reviews on the topic include studies with varied PA interventions for sarcopenia; nevertheless, no systematic review exploring the effects of PA in general on sarcopenia has been published. The main aim of this study was to explore the relationship between PA and sarcopenia in older people on the basis of cross-sectional and cohort studies. We searched PubMed, Scopus, EBSCOhost, and ScienceDirect for articles addressing the relationship between PA and sarcopenia. Twenty-five articles were ultimately included in the qualitative and quantitative syntheses. A statistically significant association between PA and sarcopenia was documented in most of the studies, as well as the protective role of PA against sarcopenia development. Furthermore, the meta-analysis indicated that PA reduces the odds of acquiring sarcopenia in later life (odds ratio [OR] =0.45; 95% confidence interval [CI] 0.37–0.55). The results of this systematic review and meta-analysis confirm the beneficial influence of PA in general for the prevention of sarcopenia.

Using relative handgrip strength to identify children at risk of sarcopenic obesity

Identifying children at risk of developing childhood sarcopenic obesity often requires specialized equipment and costly testing procedures, so cheaper and quicker methods would be advantageous, especially in field-based settings. The purpose of this study was to determine the relationships between the muscle-to-fat ratio (MFR) and relative handgrip strength, and to determine the ability of handgrip strength relative to body mass index (grip-to-BMI) to identify children who are at risk of developing sarcopenic obesity. Grip-to-BMI was measured in 730 Czech children (4 to 14 yrs). Bioelectrical impedance was used to estimate body fat mass and skeletal muscle mass, from which the MFR was calculated. The area under the curve (AUC) was 0.791 (95% CI 0.692–0.890, p ˂ 0.001) in girls 4–9; 0.789 (95% CI 0.688–0.890, p ˂ 0.001) in girls 10–14 years old; 0.719 (95% CI 0.607–0.831, p = 0.001) in boys 4–9; and 0.896 (95% CI 0.823–0.969, p ˂ 0.001) in boys 10–14 years old. Calculated using the grip-to-BMI ratio, the OR (95% CI) for girls to be at risk of sarcopenic obesity identified by MFR was 9.918 (4.243–23.186, p ˂ 0.001) and was 11.515 (4.280–30.982, p ˂ 0.001) for boys. The grip-to-BMI ratio can be used to predict the presence of sarcopenic obesity in children, which can play a role in pediatric health interventions.

Assessment of diagnostics tools for sarcopenia severity using the item response theory (IRT)

ObjectiveTo use the item response theory (IRT) methods to examine the degree to which the four selected tools reflect sarcopenia and to arrange them according to their ability to estimate sarcopenia severity.DesignA cross-sectional study aimed at verifying the possibilities of using diagnostic tools for sarcopenia.Setting and ParticipantsThe study included residents living in an assisted living unit at the Senior Centre in Blansko (South Moravia, Czech Republic) (n=77). Sarcopenia was estimated according to the proposals of the European Working Group on Sarcopenia in Older People (EWGSOP) using calf circumference, the EWGSOP algorithm, hand grip strength, and the Short Physical Performance Battery (SPPB).ResultsThe results from the IRT model showed that these four methods indicate strong unidimensionality so that they measure the same latent variable. The methods ranked according to the discrimination level ranging from high to low discrimination where the calf circumference was the most discriminatory (Hi = 0.86) and the SPPB together with hand grip strength were the least discriminatory (both Hi = 0.44).ConclusionWe are recommending to identify mild sarcopenia by SPPB or hand grip strength, moderate sarcopenia by the EWGSOP algorithm and severe sarcopenia by the calf circumference.

The increase in health care costs associated with muscle weakness in older people without long-term illnesses in the Czech Republic: results from the Survey of Health, Ageing and Retirement in Europe (SHARE)

Muscle weakness and associated diseases are likely to place a considerable economic burden on government health care expenditure. Therefore, our aim for this study was to estimate the direct and indirect costs associated with muscle weakness in the Czech Republic. We applied a cost-of-illness approach using data from the Survey of Health, Ageing and Retirement in Europe (SHARE). Six hundred and eighty-nine participants aged 70 years and over and without any long-term illnesses were included in our study. A generalized linear model with gamma distribution was used, and odds ratio (OR) was calculated in order to explore the effect of muscle weakness on direct and indirect costs. For both genders, muscle weakness had a statistically significant impact on direct costs (OR =2.11), but did not have a statistically significant impact on indirect costs (OR =1.08) or on total cost (OR =1.51). Muscle weakness had the greatest statistically significant impact on direct costs in females (OR =2.75). In conclusion, our study has shown that muscle weakness may lead to increased direct costs, and consequently place a burden on health care expenditure. Therefore, the results of this study could lead to greater interest in the prevention of muscle weakness among older people in the Czech Republic.

Hip extension strength: Description and validity of a new procedure applied to older women

OBJECTIVE: We sought to: 1) describe a new procedure for measuring hip extension strength and 2) examine the convergent and known-groups validity of measurements obtained using the procedure. METHOD: Forty women (72–98 years) volunteered for this cross-sectional, observational study of muscle strength and mobility. Hip extension strength as well as hip flexion and knee extension and flexion strengths were measured using a hand-held dynamometer (HHD). Hip extension strength was measured while participants were supine and the HHD was positioned under their slightly elevated distal leg. Participants were dichotomized as independent or dependent in sit-to-stand and walking. RESULTS: Hip extension strength was measured without difficulty or untoward effects. Relative to other ipsilateral measures of hip and knee strength, hip extension strength was found to correlate significantly (r = 0.345–0.584), to be internally consistent (alpha = 0.785 and 0.751), and to load strongly (0.733 and 0.705) on a common construct-lower limb strength. Hip extension strength (left+ right/body weight) discriminated (albeit weakly) between known groups, that is, participants who were dependent versus independent in sit-to-stand and walking. CONCLUSION: Based on these findings we recommend this procedure for measuring hip extension strength in older adults.

Association between clinical measures of sarcopenia in a sample of community-dwelling women

BACKGROUND: Sarcopenia is defined as a loss of muscle mass and strength as well as a reduction in physical performance with aging. This study was undertaken to examine the association between specific measures of muscle mass, muscle strength, and physical performance in older women. METHODS: Sixty-nine community-dwelling women with an average age of 66 years (range 60–79) participated in this study. Their muscle mass was described using bioelectric impedance analysis (BIA), their muscle strength was characterized using hand-grip dynamometry (HGD) and their physical performance was denoted using gait speed. Associations between the measures were examined using Pearson correlations and factor analysis. RESULTS: The correlation between muscle mass and muscle strength was strong and significant (p < 0.001), whereas the correlation between both variables and gait speed was poor and not significant. The factor analysis showed that gait speed (loading = −0.235) was not part of the same component as muscle mass and grip strength. CONCLUSIONS: Muscle mass and muscle strength were very closely linked with one another but not with gait speed. Muscle mass and strength represent a different component of sarcopenia than physical performance, at least as represented by gait speed.

The Role of Visual Feedback on Power Output During Intermittent Wingate Testing in Ice Hockey Players

Background: Visual feedback may help elicit peak performance during different types of strength and power testing, but its effect during the anaerobic Wingate test is unexplored. Therefore, the purpose of this study was to determine the effect of visual feedback on power output during a hockey-specific intermittent Wingate test (AnWT6x6) consisting of 6 stages of 6 s intervals with a 1:1 work-to-rest ratio. Methods: Thirty elite college-aged hockey players performed the AnWT6x6 with either constant (n = 15) visual feedback during all 6 stages (CVF) or restricted (n = 15) visual feedback (RVF) where feedback was shown only during the 2nd through 5th stages. Results: In the first stage, there were moderate-to-large effect sizes for absolute peak power (PP) output and PP relative to body mass and PP relative to fat-free mass. However, the remaining stages (2–6) displayed small or negligible effects. Conclusions: These data indicate that visual feedback may play a role in optimizing power output in a non-fatigued state (1st stage), but likely does not play a role in the presence of extreme neuromuscular fatigue (6th stage) during Wingate testing. To achieve the highest peak power, coaches and researchers could provide visual feedback during Wingate testing, as it may positively influence performance in the early stages of testing, but does not result in residual fatigue or negatively affect performance during subsequent stages.

Electronic patient records as a tool to facilitate care provision in nursing homes: an integrative review

ABSTRACT Objective: The electronic patient record (EPR) has been introduced into nursing homes with the aim of reducing time spent on documentation, improving documentation quality and increasing transferability of information, all of which should facilitate care provision. However, previous research has shown that EPR may be creating new burdens for staff. The purpose of this literature review is to explore how EPR is facilitating or hindering care provision in nursing homes. Methods: An integrative literature review was carried out using four electronic databases to search for relevant articles. After screening, 22 articles were included for thematic synthesis. Results: Thematic synthesis resulted in six analytical themes linked to care provision: time for direct care; accountability; assessment and care planning; exchange of information; risk awareness; and person-centered care. Conclusion: For EPR to facilitate care provision in nursing homes, consideration should be given to the type of device used for documentation, as well as the types of applications, the functionality, content, and structure of EPR. Further research exploring the experiences of end users is required to identify the optimal characteristics of an EPR system specifically for use in nursing homes.

Field-Based and Lab-Based Assisted Jumping: Unveiling the Testing and Training Implications

Purpose: Assisted jumping can supplement resistance training and traditional plyometric training to increase vertical jump performance. However, as coaches may choose to make field-based decisions based on lab-based research, this study determined whether a field-based assisted jumping set-up results in different ground contact times (CT), take off forces (TOF), flight times (FT), and impact forces (IF) compared to a lab-based set-up. Methods: Eighteen active males (24.8 ± 3.0 yr; 178.8 ± 7.8 cm; 77.8 ± 7.8 kg) performed two sessions of assisted jumping: one with each hand holding a commercially available resistance band (1m) that was attached to a pull-up bar (FIELD), and the other with assistance from a custom-built system of ropes, pulleys, and long (3 m) elastic bands (LAB). With each set-up, subjects performed five sets of five countermovement jumps on a force plate. Each set was performed with either bodyweight (BW), 90, 80, 70, or 60% of BW, which was achieved by either grabbing higher or lower on the bands during FIELD, or by being pulled upward via a full-body harness during LAB. The order of each visit was counter-balanced, and the order of jumps within each visit was quasi-randomized. Data from the 90, 80, 70, and 60% trials for each set-up were then expressed relative to the data of BW jumps, and these relative values were then used for analysis. Results: CTFIELD was less than CTLAB at 80, 70, and 60%. FTFIELD was greater than FTLAB at 90 and 80%, but FTLAB became greater at 60%. TOF and IF remained unchanged during LAB, but TOFFIELD was consistently less than TOF during BW, with IFFIELD generally being greater than IFLAB. Conclusion: If the purpose of assisted jumping is to spend less time on the ground without decreasing force, systems with finite adjustments and longer bands like LAB should be used. However, shorter bands similar to FIELD may also be used; but due to the larger variability of assistance throughout the range of motion, such systems may alter the neuromuscular characteristics of the jump in other ways that should be investigated in future research.